Provider Demographics
NPI:1750506879
Name:PRITCHETT, JOHN C (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9602 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-4504
Mailing Address - Country:US
Mailing Address - Phone:317-898-9473
Mailing Address - Fax:317-898-4811
Practice Address - Street 1:9602 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-4504
Practice Address - Country:US
Practice Address - Phone:317-898-9473
Practice Address - Fax:317-898-4811
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120096831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics